Objective: Internet weight loss programs have become widely available as alternatives to standard treatment, but few data are available on their efficacy. This study aimed to investigate the effectiveness of a structured behavioral weight loss website (VTrim) vs. a commercial weight loss website (http://eDiets.com). Research Methods and Procedures: A randomized, controlled trial was conducted from February 2003 to March 2005, in 124 overweight and obese subjects ages 18 years and older with a BMI of 25 to 39.9 kg/m2 (mean age, 47 ± 9 years; BMI, 32 ± 3 kg/m2; 20% men). Analyses were performed for the 88 subjects who had complete follow‐up data. Participants were randomly assigned to 12‐month VTrim (n = 62) or http://eDiets.com (n = 62) intervention. VTrim participants had access to a therapist‐led structured behavioral weight loss program delivered on‐line. http://eDiets.com subjects had access to a self‐help commercial on‐line weight loss program. Body weight, social support, and use of website components were measured at 0, 6, and 12 months. Results: Repeated‐measures analyses showed that the VTrim group lost significantly more weight than the http://eDiets.com group at 6 months (8.3 ± 7.9 kg vs. 4.1 ± 6.2 kg; p = 0.004) and maintained a greater loss at 12 months (7.8 ± 7.5 kg vs. 3.4 ± 5.8 kg; p = 0.002). More participants in the VTrim group maintained a 5% weight loss goal (65% vs. 37.5%; p = 0.01) at 12 months. Discussion: An on‐line, therapist‐led structured behavioral weight loss website produced greater weight loss than a self‐help commercial website. Because commercial sites have great potential public health impact, future research should investigate the feasibility of incorporating a more structured behavioral program into a commercial application.
OBJECTIVE:The purpose of this study was to investigate the effectiveness of a weight maintenance program conducted over the Internet. DESIGN: Longitudinal, clinical behavioral weight loss trial with 6-month in-person behavioral obesity treatment followed by a 12-month maintenance program conducted both in-person (frequent in-person support; F-IPS, minimal in-person support; M-IPS) and over the Internet (Internet support; IS). SUBJECTS: A total of 122 healthy, overweight adults (age ¼ 48.4 AE 9.6, BMI ¼ 32.2 AE 4.5 kg=m 2 , 18 male) MEASUREMENTS: Body weight, dietary intake, energy expended in physical activity, attendance, self-monitoring, comfort with technology. RESULTS: Results (n ¼ 101) showed that weight loss did not differ by condition during treatment (8.0 AE 5 vs 11 AE 6.5 vs 9.8 AE 5.9 kg, P ¼ 0.27 for IS, M-IPS and F-IPS, respectively). The IS condition gained significantly more weight than the F-IPS group during the first 6 months of weight maintenance ( þ 2.2 AE 3.8 vs 0 AE 4 kg, P < 0.05) and sustained a significantly smaller weight loss than both in-person support groups at the 1 y follow-up ( 7 5.7 AE 5.9 vs 7 10.4 AE 9.3 vs 7 10.4 AE 6.3 kg, P < 0.05 for IS, M-IPS and F-IPS, respectively). Attendance at maintenance meetings was greater for the F-IPS than the IS condition over the 1 y maintenance program (54 vs 39%, P ¼ 0.04). Acceptability of assigned condition was higher for subjects in the F-IPS than IS condition. CONCLUSION: The results of this study suggest that Internet support does not appear to be as effective as minimal or frequent intensive in-person therapist support for facilitating the long-term maintenance of weight loss.
Supplementation of an Internet weight-loss treatment with monthly in-person meetings did not result in greater weight losses over 12 months. Dynamic, socially supportive, and interactive elements of the Web site may have obviated the need for further interpersonal behavioral counseling.
HARVEY-BERINO, JEAN, BETH CASEY GOLD, RENEE LAUBER, AND AMY STARINSKI. The impact of calcium and dairy product consumption on weight loss. Obes Res. 2005;13:1720 -1726. Objective: Recent evidence suggests that diets high in calcium and dairy products are associated with lower body weight, particularly lower body fat levels. The purpose of this study was to compare weight and body fat loss on a calorie-restricted, low-dairy (CR) vs. high-dairy (CRϩD) diet. Research Methods and Procedures: Fifty-four subjects (BMI 30 Ϯ 2.5 kg/m 2 , 45 Ϯ 6.6 years, 4 men) were randomly assigned to calorie-restricted (Ϫ500 kcal/d) lowdairy calcium (n ϭ 29; ϳ1 serving dairy/d, 500 mg/d calcium) or high-dairy calcium (n ϭ 25; 3 to 4 servings dairy/d, 1200 to 1400 mg/d calcium) diets for 12 months. Main outcome measures included change in weight (kilograms) and body fat (percentage). Results: There were no significant differences between groups at baseline. At 12 months, weight and body fat loss were not significantly different. Subjects in the CR vs. CRϩD conditions lost 9.6 Ϯ 6.5 vs. 10.8 Ϯ 5.9 kg (p ϭ 0.56) and 9.0 Ϯ 3.8 vs. 10.1 Ϯ 3.6 kg body fat (p ϭ 0.37). Discussion: These findings suggest that a high-dairy calcium diet does not substantially improve weight loss beyond what can be achieved in a behavioral intervention.
Dietary self-monitoring is considered the core of behavioral weight control programs. As software for personal digital assistants (PDA) has become more available, this study investigated whether the use of a PDA would improve dietary self-monitoring frequency and subsequent weight loss over the use of traditional paper diaries. One-hundred-seventy-six adults (BMI 25-39.9) participated in a 6-month behavioral weight control program. Treatment subjects (n = 61) were provided with a PalmZire 21 with Calorie King's Diet Diary software installed. Their self-monitoring habits and weight loss were compared with the results from a previous program (n = 115) which followed the same protocol using paper diaries for self-monitoring. No significant differences in weight loss or dietary self-monitoring were found. More frequent self-monitoring correlated with weight loss in both groups (p<.001). People seeking to lose weight should be encouraged to self-monitor and be matched with a mode of self-monitoring that is fitting to their lifestyle and skills.
MCKENZIE, DEBRA C., RACHEL K. JOHNSON, JEAN HARVEY-BERINO, AND BETH CASEY GOLD. Impact of interviewer's body mass index on underreporting energy intake in overweight and obese women. Obes Res. 2002;10:471-477. Objective: To determine if overweight and obese women provide more accurate reports of their energy intake by 1) in-person recall with an obese interviewer, 2) in-person recall with a lean interviewer, or 3) telephone recall with an unknown interviewer. Research Methods and Procedures: Eighty-eight overweight and obese women participated in this study. Subjects completed one telephone-administered multiple-pass 24-hour recall (MP24R) with an unknown interviewer and were then randomly assigned to an in-person MP24R with either a lean or obese interviewer to gather reported energy intake (rEI). Basal metabolic rate (BMR) was measured using a Deltrac monitor, and physical activity (EEPA) was estimated using a Caltrac accelerometer. Therefore, estimated energy expenditure was determined by: estTEE ϭ (BMR ϩ EEPA) ϫ 1.10. Results: No significant differences were found between the two in-person interview modes for subject age, weight, body mass index, percentage of body fat, total energy expenditure, rEI, and misreporting of energy intake. In-person recall data were combined for comparison with the telephone recalls. No significant difference was found between the in-person and telephone recalls for rEI and misreporting. Mean reported energy intake was significantly lower than estimated total energy expenditure for the telephone recalls and combined (lean and obese modes) in-person recalls. Conclusions: This study found that interviewer body mass index had no impact on self-reported energy intake during an in-person MP24R, and that telephone recall data were comparable with in-person recalls. Underreporting was a widespread problem (ϳ26%) for all modes in this sample.
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